Nitroglycerin (NTG, Nitro) Flashcards
1
Q
Nitro - Class
A
Nitrate/Vasodilator
2
Q
Nitro - Actions
A
Causes vasodilation, thereby:
- Decreases blood return to the right heart (preload)
- Decreases myocardial workload
- Decreases myocardial O2 consumption
- Increased perfusion through coronary vessels to myocardium
3
Q
Nitro - Indications
A
- CP of a suspected cardiac origin
* Respiratory distress of suspected cardiac origin (CHF)
4
Q
Nitro - Dosage/Route
A
- CP of suspected cardiac origin
- 0.4 mg (gr 1/150) SL or spray, q 5 min X 3 (if BP >90 systolic)
- Respiratory distress of suspected cardiac origin (CHF)
- 0.8 mg (two 1/150 gr) SL or spray q 5 min X 3 for severe distress (if BP >150 systolic)
- 0.4 mg (1/150 gr) SL or spray q 5 min X 3 (if BP 100-150 systolic)
- May repeat prn
5
Q
Nitro - Side Effects
A
- Transient hypotension (can be profound)
* Temporary, pulsating headache &/or facial flushing
6
Q
Nitro - Contraindications
A
Shock & suspected intracranial bleeding
7
Q
Nitro - Special Information
A
- Assess effectiveness by pt reassessment
- Store in dark container and replace opened bottle every 30 days
- If hypotension develops, consider fluid challenge
- Prepare pt for admin - Start an IV (recommended if blood pressure is borderline low, but not required prior to admin)
- Ask pts if they are on drugs for erectile dysfunction and if so, the dose and last time taken
- No NTG should be given under SO to a pt who has taken Viagra (sildenafil) or Levitra (vardenafil) within the last 24 hrs, or Cialis (tadalafil) within the last 48 hours
- If pt on Viagra, etc. is having CP & OLMC cannot be reached, an IV line should be started & small doses of morphine given with prn fluid blouses instead of NTG
- Check BP before & after admin
- Some brands do not cause bitter taste under tongue, as in past - not a reliable indicator of potency
8
Q
Nitro - Pediatric Note
A
Not indicated
